Diabetes and COPD

The Effects of High Blood Sugar on COPD

High Blood Sugar on Glucose Meter
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Studies tell us that roughly 15 percent of all patients with chronic obstructive pulmonary disease or COPD who are admitted to the hospital also have diabetes, but does this mean having COPD puts you at greater risk for diabetes? Or, is the co-existence of these conditions instead related to a shared risk factor, such as smoking and inflammation?

How do these conditions influence the course of the other condition and what do you need to know if you have both COPD and diabetes?

Inflammation, COPD, and Diabetes

There are two types of inflammation—acute and chronic. Acute inflammation is a short-term immune response to a sudden sustained injury. If you cut your finger, for example, by the next day it is probably going to be red and swollen. This is good news because it means the inflammatory response has kicked in, releasing a plethora of pro-inflammatory chemicals to fight against foreign invaders possibly introduced into your body by the cut on your finger. The inflammatory response occurs in many different stages, with the end result being healing (in an otherwise healthy person.)

Chronic inflammation, on the other hand, occurs when the inflammatory response won't turn off and the immune system keeps pumping out inflammatory chemicals. It is often the result of certain lifestyle factors—stress, lack of exercise, and a poor diet—that, over time, cause inflammation to occur even when it isn't necessary and can be detrimental.

It is becoming increasingly evident that chronic inflammation is at the root of many chronic diseases, including COPD and diabetes.

What the Research Says About COPD and Diabetes

While you may have a greater chance of having diabetes if you have COPD, there is no prospective data demonstrating that people with COPD have a greater risk of developing diabetes.

In fact, an article published in the journal Thorax reports that there is a reduction in diabetes in older-aged patients who have COPD. If diabetes is associated with COPD, the greatest effects are seen in the youngest of COPD patients who smoke and those between the ages of 45-55 who have never smoked.

Diabetes does appear to worsen both the progression and prognosis of COPD. This may be because diabetes increases susceptibility to infections, such as those associated with COPD exacerbations.

The Effects of High Blood Sugar on COPD

Research has shown that hyperglycemia (high blood sugar) is linked to impaired lung function. One study showed that diabetes was associated with a lower FEV1 and FVC, an association that was made worse by smoking. The same study found that an increase in fasting blood sugar was associated with a lower residual FEV1.

Why would diabetes and subsequent high blood sugar affect the lungs? Possible links include:

  • An increase in body mass index (BMI)
  • Loss of respiratory compliance (the ability of the lungs to distend) associated with diabetes
  • Damage to the nervous system (diabetic neuropathies)
  • Weakened respiratory muscles

High blood sugar has also been associated with poor outcomes in hospitalizations due to COPD exacerbation, leading to longer hospital stays and premature death.

Does Smoking Make the Effect of Diabetes on the Lungs Worse?

In people who smoke, the adverse effects of diabetes on lung function are even greater. Diabetics who smoke can minimize the consequences related to smoking by maintaining adequate blood sugar control and reducing risk factors that predispose them to a further decrease in lung function, like smoking or exposure to secondhand smoke.

What Will Improve Your Blood Sugar and COPD?

What else can you do to manage both diabetes and COPD? Let's take a look:

  • First and foremost, quit smoking by utilizing a variety of smoking cessation products and resources.
  • Start a pulmonary rehabilitation program or another exercise group, which will not only help with blood sugar control but with improving your COPD symptoms as well. The role of even mild to moderate amount of exercise on both of these conditions cannot be overstated. Even gardening a few times weekly may improve both conditions. That said, daily exercise is recommended for the greatest benefit.
  • Adhere to your medication regimen prescribed by your doctor, whether you have diabetes, COPD, or both. Studies tell us that skipping medications (or follow-up visits) can lead to poorer control with both of these conditions. Find ways of making sure you don't miss your medications, whether that means using a calendar or a pill box. In addition, if cost is an issue, check the many prescription benefit programs which offer medications at a reduced cost.

When Should You Contact the Doctor About Diabetes?

If you have diabetes, make sure you know the signs and symptoms of both hypoglycemia (low blood sugar) and hyperglycemia. If you experience any of these signs or symptoms, talk to your health care provider as soon as possible.

COPD, Diabetes and Lung Cancer

It's becoming well-known that COPD is an independent risk factor for lung cancer. For uncertain reasons, however, it's thought that among people with COPD, type II diabetes may have a protective effect against the development of lung cancer, with fewer people with co-existing COPD and diabetes developing lung cancer than those with COPD alone. This certainly does not mean that it is a good idea to develop diabetes if you have COPD, but may offer some comfort for those who are facing this combination of conditions.

Bottom Line on COPD and Diabetes

At the current time, we aren't certain exactly how COPD and diabetes interact or how they influence each other, though it does appear that inflammation is an underlying factor in both conditions. Thankfully, measures taken to improve your COPD may help your diabetes, and vice versa. It's likely that these health measures will also result in improvements of other conditions related to inflammation ranging from heart disease to cancer.

Sources:

Glaser, S., Kruger, S., Merkel, M., Bramlage, P., and F. Herth. Chronic Obstructive Pulmonary Disease and Diabetes Mellitus: A Systematic Review of the Literature. Respiration. 2015. 89(3):253-64.

Herth, F., Bramlage, P., and D Muller-Wieland. Current Perspectives on the Contribution of Inhaled Corticosteroids to an Increased Risk for Diabetes Onset and Progression in Patients with Chronic Obstructive Pulmonary Disease. Respiration. 2015. 89(1):66-75.

Shen, T., Chung, W., Lin, C. et al. Does Chronic Obstructive Pulmonary Disease With or Without Type 2 Diabetes Mellitus Influence the Risk of Lung Cancer? The result from a Population-Based Cohort Study. PLoS One. 2014. 9(5):e98290.

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